Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used medications worldwide. The availability of hundreds of products containing an NSAID, combined with a lack of recognition and understanding of NSAIDs, can increase the potential of consumers to inadvertently exceed the recommended NSAID dosage, which can cause potentially serious side effects. Physician and consumer education regarding the appropriate use of NSAIDs can help prevent NSAID misuse. Evaluations of current consumer patterns of NSAID use and perceptions about NSAIDs are necessary to develop targeted educational programs. Materials and Methods: An online and telephone survey of 1,750 U.S. adults was conducted to obtain information about the patterns of use and perceptions about prescription and over-the-counter NSAIDs and medicines. The survey was compared to similar surveys conducted in 1997, 2001 and 2002. Results: NSAIDs are widely used, with 63% of respondents reporting use within the past 12 months. NSAIDs were not well recognized by generic or brand names and many respondents were unaware or unconcerned about potential side effects. NSAID misuse was common, with 19% using more than the recommended dose and 24% using multiple NSAIDs concomitantly. NSAID use appears to have increased since 2002 but the level of NSAID awareness and pattern of NSAID misuse has not changed. Conclusions: NSAIDs are widely used and often used in a manner that increases the risk of serious side effects. Sufficient knowledge and understanding of NSAIDs is lacking and educational interventions directed to consumers and physicians are needed.